Insomnia In Individuals Research Articles

Validation and efficacy of a tele-yoga intervention for improving psychological stress, mental health and sleep difficulties of stressed adults diagnosed with long COVID: a prospective, multi-center, open-label single-arm study

The objective of this study was to validate and test the efficacy of a 16-week tele-yoga intervention for perceived stress, anxiety, depression, and insomnia in individuals who had had COVID-19 infection in the previous year, and had reported moderately high levels of psychological stress (PSS ≥14). 25 and 50-min versions of the program were developed. They were then validated using Lawshe’s content validity ratio after obtaining feedback from 20 yoga therapy experts. The safety and efficacy of the two programs were subsequently tested in a prospective, multicenter, open-label single-arm study. Eighty-six adults (18 male, 68 female) were recruited from two tertiary mental healthcare institutions, 48 in NIMHANS, Bengaluru; and 38 in SCARF, Chennai. Participants were assessed at weeks zero, 4, and 16 using validated tools. Data were analyzed using a Mixed Model, Intention to Treat approach. After week 16, 31 subjects remained in the trial and continued to practice yoga without any side effects. Subjects who adhered in the trial had significantly higher levels of baseline anxiety and depression as compared to subjects who dropped out. Results at week 4 included significant reductions in levels of perceived stress, anxiety, and insomnia; improvements were maintained at week 16. Correlations between number of yoga sessions and post-intervention PSS scores were negative (r = −0.49), and significant (p< 0.05). Both tele-yoga programs proved safe, useful tools to counteract perceived stress, anxiety and insomnia. Future trials should explore the utility of tele-yoga as a tool to enhance well-being and manage stress.

Interplay of Sleep Quality, Insomnia and Quality of Life in Individuals Undergoing Hemodialysis

Insomnia is the most commonly occurring disorder of sleep experienced by individuals with chronic kidney disease. It is associated with physical and psychological health issues specifically the ones on hemodialysis. Objective: To find out the frequency of insomnia in individuals undergoing hemodialysis and to examine the relationship between sleep quality and quality of life. Methods: It was a cross sectional study and non-probability purposive sampling technique was used for selecting the sample of patients undergoing hemodialysis from a dialysis center of Lahore. The sample consisted of both men and women (N=100) with age range 40 and above (M=51.40, SD=7.25). Insomnia, general sleep scale and quality of life scale were used to collect data from the participants. Results: Insomnia was found to be prevalent in 6% of the patients. Quality of Life (QOL) was significantly poor in individuals with insomnia and poor sleep quality as compared to the ones with better sleep. Older age, increasing duration of hemodialysis and poor sleep quality were significant predictors of quality of life in our sample. Conclusions: Insomnia and/or poor-quality sleep have a detrimental effect on patients’ quality of life in kidney disease. These findings can provide basis for awareness campaigns and health promotion programs aimed at timely diagnosis and management of insomnia and improvement in sleep quality as well as quality of life in individuals undergoing hemodialysis

Cognitive Behavioral Therapy for Insomnia Improves Sleep Outcomes in Individuals With Concussion: A Preliminary Randomized Wait-List Control Study.

Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for insomnia, but there is limited evidence on the treatment effect of CBT-I in individuals after a concussion. Therefore, the main purpose of this study was to evaluate the treatment effect of CBT-I on sleep outcomes and postconcussion symptoms. This study was conducted at an academic institution. The CBT-I sessions were conducted using a teleconferencing system (Zoom). Participants were eligible to participate if they were at least 4 weeks post- concussion, aged 18 to 64 years, and scored 10 or more on the Insomnia Severity Index. A total of 40 people were enrolled; 32 participants were included in analyses. This was a randomized controlled wait-list study. Participants were randomized into starting the CBT-I intervention immediately after the baseline assessment or into the wait-list group for 6 weeks before starting CBT-I. Assessments were performed at baseline, 6, 12, and 18 weeks. The primary outcome was the Insomnia Severity Index. Secondary measures included the Pittsburg Sleep Quality Index, Post-Concussion Symptom Scale, and Beck Depression and Anxiety Inventories. Statistical analyses included a repeated-measures analysis of variance, t tests, and mixed linear regression modeling. There was a group-by-time interaction for the sleep outcomes but not for the concussion or mood outcomes. Differences were seen between groups on sleep outcomes, symptom severity, and depression. The treatment effect was maintained following CBT-I for all outcomes. Improvement in sleep outcomes was predictive of improvement in postconcussion symptom severity and number of symptoms. CBT-I reduces insomnia in individuals with concussions, and improved sleep was associated with lower postconcussion and mood symptoms. These effects were maintained 6 to 12 weeks following the intervention.

Association of Cold/Heat Sensation with Sleep Quality and Insomnia in Middle-aged Women

Objectives: Cold extremities have been suggested to correlate with sleep disturbances. This study aims to explore the relationship between thermal sensations in body, encompassing both cold and heat sensations, with sleep quality and insomnia.Methods: Self-administered questionnaires were utilized to assess thermal sensations in body, sleep quality and symptoms of insomnia in middle-aged women. A multiple logistic regression analysis was performed to ascertain the association between thermal sensations in body and both sleep quality and insomnia symptoms.Results: Among 899 participants, 255 (28.4%) were categorized in the cold sensation group, 95 (10.6%) in the heat sensation group, 70 (7.8%) in the group with both cold and heat sensations, and 479 (53.3%) in the no-sensation group. Pittsburgh Sleep Quality Index and Insomnia Severity Index were notably higher in the group experiencing both sensations when compared to the no-sensation group. After adjustments for covariates, the odds ratios for poor sleep quality, moderate/severe insomnia, and long sleep latency were significantly elevated in the group with both sensations when compared to the no-sensation group. The odds ratios for poor sleep quality in the cold sensation group and for moderate/severe insomnia and low sleep efficiency in the heat sensation group were significantly higher when compared to the no-sensation group.Conclusions: The risk for sleep disturbances varied depending on the presence of thermal sensations in body, with the greatest risk observed for low sleep quality and insomnia in individuals experiencing both cold and heat sensations.

Structural validity of nursing diagnosis insomnia in older adults of a community center.

Insomnia is an important sleep disorder in older persons. Conceptual analysis studies on this nursing diagnosis have been developed, but the diagnostic accuracy has not been verified. This study aimed to verify the diagnostic accuracy of the nursing diagnosis of Insomnia (00095) in older adults in a community center in Brazil. A validation study for diagnostic accuracy of the defining characteristics of the nursing diagnosis Insomnia. Data were collected through telephone interviews with 90 participants. Latent class analysis was used to verify the sensitivity and specificity of the defining characteristics. Poisson regression was used to assess the prevalence of the association of factors related to the nursing diagnosis of insomnia. A 47.42% prevalence of insomnia in the sample was identified. Defining characteristics such as expresses dissatisfaction with sleep and nonrestorative sleep-wake cycle showed the best accuracy values for insomnia, with a specificity of 0.92 (0.78-1.00) and 0.89 (0.74-1.00), respectively. Related factors such as stressors and frequent naps during the day were more likely to develop insomnia in individuals. This study indicates diagnostic accuracy of nursing diagnosis of insomnia in community-dwelling older people from a community center. The findings highlighted the importance of the defining characteristics of nursing diagnosis insomnia and its main related factors contributing to accurate diagnostic identification. This study can contribute to providing objective clinical indicators of insomnia in the older population to guide nurses in early diagnostic confirmation for the selection of health interventions. In addition, it can be a consistent contribution to theoretical and conceptual reviews ofthisdiagnosis.

Insomnia and Cardiovascular Health: Exploring the Link Between Sleep Disorders and Cardiac Arrhythmias.

Cardiovascular diseases (CVDs), driven by modern lifestyles, have increased, with atrial fibrillation (AF) being a major concern linked to heart failure and stroke. Insomnia affects a large population, especially younger individuals, males, and menopausal women, decreasing the quality of life and potentially causing autonomic disturbances and cardiac arrhythmias. PURPOSE OF REVIEW: This review explores the link between insomnia and cardiac arrhythmias, particularly AF, and its impact on cardiovascular health and emphasizes the need to address insomnia in individuals with cardiac arrhythmias by tailored strategies for sleep management to improve their overall well-being. RECENT FINDINGS: Recent findings emphasize maintaining a regular sleep schedule to lower AF and bradyarrhythmia risks. Better sleep scores correlate with reduced AF and bradyarrhythmia risks, while insomnia increases AF risk, particularly in those under 40years of age. Studies underscore the potential impact of sleep management in reducing cardiovascular risks and highlight the importance of addressing sleep issues to improve cardiovascular health outcomes. Our review presents compelling evidence connecting insomnia and AF. Improving sleep patterns and addressing sleep issues can reduce AF risk, benefiting cardiovascular health. A comprehensive approach for managing at-risk individuals with cardiac arrhythmias, considering co-existing conditions, can decrease long-term disease burden and expenses. Incorporating sleep assessments and interventions into cardiovascular risk management, especially for those with insomnia, is recommended. Further research is needed to fully comprehend the complex relationship between insomnia and cardiac arrhythmias.

Circadian typologies and insomnia in individuals with internet gaming disorder comorbid with attention deficit/hyperactivity disorder

The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects this relationship. We recruited three groups of 69 young adults: an IGD group, a control group comprising age- and sex-matched nongamers, and a group of gamers without IGD through diagnostic interviews. The participants with IGD exhibited lower composite scale of morningness (CSM) scores and thus a higher eveningness preference In addition, the score of Pittsburgh insomnia rating scale—20-item version (PIRS_20) was significantly higher among those with IGD. The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD. The present findings indicate that participants with IGD exhibited a tendency of eveningness preference and experienced more severe insomnia. ADHD exacerbated the eveningness preference and insomnia of individuals with IGD. Close attention should be paid to sleep problems in individuals with IGD, particularly to those with ADHD.

0366 Understanding the mediating role of sleep improvement on anxiety symptoms using digital CBT for insomnia

Abstract Introduction Insomnia has significant overlap with anxiety, and CBT for insomnia, in addition to improving sleep, leads to concomitant reductions in anxiety. Nevertheless, few studies have evaluated the anxiolytic effects of CBT for insomnia in individuals with insomnia and clinically significant anxiety symptoms or an anxiety disorder diagnosis. Large studies of digital CBT provide a prudent source to evaluate the transdiagnostic role of insomnia to reduce anxiety symptoms. Using data from two trials of dCBT for insomnia, we evaluated whether sleep is a transdiagnostic treatment target to reduce anxiety symptoms in individuals with insomnia and clinically significant anxiety. Methods Individual data from 2,172 participants with insomnia and clinically significant anxiety symptoms were extracted from two previously conducted randomised controlled trials of dCBT for insomnia. Participants received either dCBT or control (usual care or sleep hygiene education). Assessments were conducted at baseline, post-intervention (week 8 or 10), and follow-up (week 22 or 24). Insomnia symptoms were assessed using the Sleep Condition Indicator (SCI-8), and anxiety symptoms using the 7-item Generalized Anxiety Disorder scale (GAD-7). Mediation was evaluated using structural equation models. Results Compared with control, dCBT for insomnia was superior at reducing symptoms of insomnia (Hedges’ g range: 0.71-0.88; both p< 0.001) and anxiety (Hedges’ g range: 0.39-0.44; both p< 0.001). At post-intervention, participants in the dCBT group were significantly more likely to achieve remission (OR = 2.24 (0.30); < 0.001 (1.72, 2.91)) and reliable remission (OR = 2.24 (0.30); < 0.001 (1.73, 2.89)) of their anxiety. Improvements in sleep at post-intervention mediated 84% of the effect of dCBT on anxiety symptoms at follow-up. Conclusion Targeting insomnia symptoms via digital CBT for insomnia may be an appropriate means by which to reduce anxiety symptoms in individuals with insomnia and comorbid anxiety. These findings reinforce the transdiagnostic benefits of CBT for insomnia and digital CBT may offer an accessible first step intervention. Support (if any) This work was supported in part by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

0681 The Relationship between Safety Behaviors and Insomnia in individuals with Post-Traumatic Stress Disorder

Abstract Introduction Safety behaviors may perpetuate anxiety, maintain an individual’s perception of threats, and may lead to psychosocial impairment. Safety behaviors are commonly seen in those suffering from insomnia and post-traumatic stress disorder (PTSD). Despite their prevalence and associated impairments, there exists no data on the relationship between insomnia and safety behavior in those suffering from PTSD. The aim of this study is to evaluate the relationship between safety behavior and insomnia in those with PTSD. If such a relationship is seen, does the severity of nightmares or overall PTSD mediate this relationship between insomnia and safety behaviors? Methods The study extracted data from baseline assessments of a treatment study conducted at the VA Medical Center at Philadelphia. The subjects were treatment-seeking patients with PTSD (N =43). Safety behavior was evaluated using the 12-item brief Safety Behavior Assessment Form (SBAF), PTSD was evaluated using the PTSD checklist for DSM-5 (PCL-5), and insomnia with Insomnia Severity Index (ISI) scales. Bivariate analyses evaluated the relationship between SBAF total score and age, education, income, PCL-5, and ISI total scores. Nightmare severity was evaluated using item number 2 from the PCL-5 questionnaire. An analysis evaluated the role of the severity of nightmares or PTSD (PCL-5 total score after excluding the sleep and safety items) as independent mediators in the relationship between SBAF and ISI total scores. Results The mean±standard deviation of their age was 56.1±11.6 years and 13.1±2.1 years of education. They were mostly males (86.0%), black (61.9%) and unemployed over the past month (76.8%). The mean total score was 17.1±5.7 on the SBAF, 17.3±7.4 on the ISI, and 52.5±14.5 on the PCL-5. Bivariate analysis demonstrated that SBAF total score was associated with the ISI (β=0.32, p=0.0005 and PCL-5 (β=0.22, p=0.0004) total scores. Mediation analysis demonstrated a significant mediation effect of nightmares (R2=24.6%) and PTSD severity (R2=33.3%) on the association between safety behaviors and insomnia. Conclusion About sixty percent of the variance in safety behaviors was explained by insomnia and its association with PTSD or nightmare severity. Treatment of underlying insomnia, PTSD, or nightmares may improve the safety behaviors associated with PTSD. Support (if any) 1IK2CX000855 (S.C.), and 1 I01 CX001957 (S.C.).

Digital cognitive behaviour therapy for insomnia in individuals with self-reported insomnia and chronic fatigue: A secondary analysis of a large scale randomized controlled trial.

Insomnia is associated with fatigue, but it is unclear whether response to cognitive behaviour therapy for insomnia is altered in individuals with co-occurring symptoms of insomnia and chronic fatigue. This is a secondary analysis using data from 1717 participants with self-reported insomnia in a community-based randomized controlled trial of digital cognitive behaviour therapy for insomnia compared with patient education. We employed baseline ratings of the Chalder Fatigue Questionnaire to identify participants with more or fewer symptoms of self-reported chronic fatigue (chronic fatigue, n=592; no chronic fatigue, n=1125). We used linear mixed models with Insomnia Severity Index, Short Form-12 mental health, Short Form-12 physical health, and the Hospital Anxiety and Depression Scale separately as outcome variables. The main covariates were main effects and interactions for time (baseline versus 9-week follow-up), intervention, and chronic fatigue. Participants with chronic fatigue reported significantly greater improvements following digital cognitive behaviour therapy for insomnia compared with patient education on the Insomnia Severity Index (Cohen's d=1.36, p < 0.001), Short Form-12 mental health (Cohen's d=0.19, p=0.029), and Hospital Anxiety and Depression Scale (Cohen's d=0.18, p=0.010). There were no significant differences in the effectiveness of digital cognitive behaviour therapy for insomnia between chronic fatigue and no chronic fatigue participants on any outcome. We conclude that in a large community-based sample of adults with insomnia, co-occurring chronic fatigue did not moderate the effectiveness of digital cognitive behaviour therapy for insomnia on any of the tested outcomes. This may further establish digital cognitive behaviour therapy for insomnia as an adjunctive intervention in individuals with physical and mental disorders.

Hospital-acquired insomnia scale: A validity and reliability study.

Sleep breathing, one of the basic human needs, is a physiological need that affects cardiac functions, body temperature, daily vitality, muscle tone, hormone secretion, blood pressure, and many more. In the international literature, studies reported that patients have had sleep problems in the hospital since the 1990s, but no measurement tool has been developed to determine the causes of hospital-acquired insomnia in individuals. These findings suggest that sleep remains in the background compared to activities such as nutrition and breathing. Although patients generally experience hospital-acquired sleep problems, there is no measurement tool to determine hospital-acquired sleep problems. These features show the originality of the research. To develop a measurement tool to determine the sleep problems experienced by patients in the hospital. A personal information form, hospital-acquired insomnia scale (HAIS), and insomnia severity index (ISI) were used to collect research data. The study population consisted of patients hospitalized in the internal and surgical clinics of a research hospital in Turkey between December 2021 and March 2022. The sample consisted of 64 patients in the pilot application stage and 223 patients in the main application stage. Exploratory factor analysis and confirmatory factor analysis (CFA) analyses were performed using the SPSS 20 package program and the analysis of moment structure (AMOS) package program. Equivalent forms method used. The HAIS consisted of 18 items and 5 subscales. The Cronbach alpha values of the subscales ranged between 0.672 and 0.842 and the Cronbach alpha value of the overall scale was 0.783. The scale explained 58.269% of the total variance. The items that constitute the factors were examined in terms of content integrity and named as physical environmental, psychological, safety, socioeconomic, and nutritional factors. CFA analysis of the 5-factor structure was performed in the AMOS package program. The fit indices of the obtained structure were examined. It was determined that the values obtained from the fit indices were sufficient. A significant correlation was determined between the HAIS and the ISI, which was used for the equivalent form method. The HAIS is a valid and reliable measurement tool for determining patients' level of hospital-acquired insomnia. It is recommended to use this measurement tool to determine the insomnia problems of patients and to adapt it in other countries.

Stress levels, psychological symptoms, and C-reactive protein levels in COVID-19: A cross-sectional study

BackgroundAlthough many studies have pointed out a possible relationship between COVID-19 and the presence of psychiatric disorders, the majority of the studies have significant limitations. This study investigates the influence of COVID-19 infection on mental health. MethodsThis cross-sectional study included an age- and sex-matched sample of adult individuals positive (cases) or negative (controls) for COVID-19. We evaluated the presence of psychiatric conditions and C-reactive protein (CRP). ResultsFindings showed greater severity of depressive symptoms, higher levels of stress, and greater CRP in cases. The severity of depressive and insomnia symptoms, as well as the CRP were more remarkable in individuals with moderate/severe COVID-19. We found a positive correlation between stress and severity of anxiety, depression, and insomnia in individuals with or without COVID-19. There was a positive correlation between CRP levels and severity of depressive symptoms in cases and controls, and a positive correlation between CRP levels and the severity of anxiety symptoms and stress levels only in individuals with COVID-19. Individuals with COVID-19 and depression had greater CRP than those with COVID-19 without current major depressive disorder. LimitationsWe cannot infer causality because this is a cross-sectional study, and the majority of COVID-19 sample was asymptomatic or had mild symptoms, which may limit the generalizability of our findings for moderate/severe cases. ConclusionsIndividuals with COVID-19 showed greater severity of psychological symptoms, which may impact on the development of psychiatric disorders in the future. CPR seem to be a promising biomarker for earlier detection of post-COVID depression.

Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder

BackgroundThe use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol. MethodsWe investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment. ResultsDepressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances. LimitationsSleep disturbances were based on items from the IDS-C questionnaire. ConclusionWe found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning.

Assessing cognitive behavioral therapy for insomnia in individuals with cannabis use disorder utilizing actigraphy and serum biomarkers: A pilot study

Objective/backgroundThis pilot study aims to assess the effect of Cognitive Behavioral Therapy for insomnia (CBTi) in individuals with cannabis use disorder and insomnia. It also aims to investigate the effect of CBTi on levels of serum inflammatory markers in relation to insomnia symptoms. Methods/patientsIndividuals with cannabis use disorder and insomnia symptoms were recruited over 18 months. Data collected included demographics, self-reported sleep parameters, and cannabis use. Blood samples were drawn to measure IL-2, IL-6, CRP, and cortisol. Participants completed the Insomnia Severity Index questionnaire (ISI) and the Patient Health Questionnaire-4 (PHQ-4), and they were provided with an actigraphy (wrist) device for 1 week before CBTi and a subsequent week after completing the 4 CBTi sessions. ResultsNineteen participants were enrolled in the study. The mean ISI score decreased from moderately severe insomnia at baseline to no clinically significant insomnia after CBTi with a sustained decrease at 3- and 6-months follow-up. Actigraphy showed a significant decrease in sleep onset latency (SOL) after CBTi. Three months after CBTi, 80% of participants reported a decrease in their cannabis use. There was also a significant and sustained decrease in mean PHQ-4 scores after CBTi. Although only trending towards significance, the levels of three out of four biomarkers (IL-2, IL-6, CRP) were decreased 6 months after CBTi. ConclusionsCBTi is effective as a short- and long-term treatment of insomnia and comorbid anxiety/depression in individuals who regularly use cannabis. A potential added benefit is a reduction in cannabis consumption and inflammatory serum biomarkers.

Interleukin-1α and tumor necrosis factor α as an inducer for reactive-oxygen-species-mediated NOD-like receptor protein 1/NOD-like receptor protein 3 inflammasome activation in mononuclear blood cells from individuals with chronic insomnia disorder.

There is some evidence that cytokines may play an important role in sleep deprivation; however, the underlying mechanisms are still unknown. So, the present study aimed to evaluate the relationship between NOD-like receptor protein 1 (NLRP1) and NOD-like receptor protein 3 (NLRP3) inflammasome activation of blood cells and serum levels of cytokines in individuals with chronic insomnia disorder (CID). Blood samples were collected from 24 individuals with CID and 24 healthy volunteers. The inflammasome activation was evaluated using real-time polymerase chain reaction of NLRP1, NLRP3, apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC) and caspase-1; western blot of NLRP1 and NLRP3; caspase-1 activity assay; and serum levels of interleukin-1β (IL-1β), IL-18 and other cytokines using enzyme-linked immunosorbent assay. Reactive oxygen species generation in blood cells were detected by flow cytometry assay. Also, magnetic resonance imaging scans were obtained on a Siemens Magnetom Avanto 1.5T MRI whole-body scanner using an eight-channel head coil. Increased activity of NLRP1 and NLRP3 inflammasomes in blood cells, increased serum levels of pro-inflammatory cytokines and decreased serum levels of IL-10 and transforming growth factor β in individuals with CID were found. Significant correlation was observed between increased serum concentration of IL-1β and the severity of insomnia in individuals with CID. The levels of reactive oxygen species in blood cells were found to be correlated with IL-1α and tumor necrosis factor α concentrations in sera from individuals with CID. Moreover, the individuals with CID demonstrated increased right cerebellum cortex and lateral ventricle mean diffusivity bilaterally compared to controls. This study provided new insights on the pathogenesis of CID and the effects of cytokines on inflammasome activation.

0429 Insomnia vs Poor Sleep: Characteristics of Sleep Complaints in a Social Media Sample

Abstract Introduction There is a tendency for individuals to interpret sleep difficulties as "poor sleep" rather than insomnia. This occurs even though when many individuals describe their symptoms, they often describe symptoms of insomnia. Indeed, they reject the label of insomnia as applying to their specific sleep difficulties. Misinterpreting chronic insomnia as simply "poor sleep" may prevent or delay treatment seeking behavior and thereby prolong/worsen associated negative outcomes. Little is known about the sleep characteristics and rate of chronic insomnia in individuals who interpret their sleep disturbance as “poor sleep.” Methods 44,439 individuals age 30+ were shown an advertisement on social media with the prompt, "Poor sleep is annoying but insomnia is a serious issue. Take this free 1-minute quiz to learn the difference between insomnia and poor sleep." 1533 clicked on the ad to view the quiz and 468 completed the quiz. We included 449 responses in the current analysis. Nineteen were excluded as no insomnia symptoms were endorsed. The quiz queried DSM-V chronic insomnia diagnostic criteria. After completing the survey, the website supplied respondents with automated feedback and education about their responses. Results The quiz did not collect demographic information. However, those who clicked on the ad were 84% female and 87% age 55+. Sixty-nine percent (n=310) of responses met full diagnostic criteria. Reasons for not meeting diagnostic criteria were 13% (n=59) no sleep dissatisfaction, 10% (n=45) symptom frequency &amp;lt;3 nights/week, 6% (n=25) symptom duration &amp;lt;3 months, 7% (n=31) denied daytime symptoms, and 5% (n-21) inadequate opportunity for sleep. 54% (n=244) endorsed short sleep duration (&amp;lt;6 hours) despite adequate opportunity for sleep. Conclusion Of community members responding to the advertisement, over 2/3 met full diagnostic criteria for chronic insomnia and over 50% appear to have the more severe phenotype of insomnia with short sleep duration. Formal study of subjective sleep disturbance interpretation may help develop effective methods for communicating with insomnia sufferers who may minimize or not recognize the seriousness of their sleep disturbance. Support (If Any) None

An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample

BackgroundLittle is known about cannabis use for insomnia in individuals with depression, anxiety, and comorbid depression and anxiety. To develop a better understanding of distinct profiles of cannabis use for insomnia management, a retrospective cohort study was conducted on a large naturalistic sample.MethodsData were collected using the medicinal cannabis tracking app, Strainprint®, which allows users to monitor and track cannabis use for therapeutic purposes. The current study examined users managing insomnia symptoms in depression (n = 100), anxiety (n = 463), and comorbid depression and anxiety (n = 114), for a total of 8476 recorded sessions. Inferential analyses used linear mixed effects modeling to examine self-perceived improvement across demographic variables and cannabis product variables.ResultsOverall, cannabis was perceived to be efficacious across all groups, regardless of age and gender. Dried flower and oral oil were reported as the most used and most efficacious product forms. In the depression group, all strains were perceived to be efficacious and comparisons between strains revealed indica-dominant (Mdiff = 1.81, 95% CI 1.26–2.36, Padj < .001), indica hybrid (Mdiff = 1.34, 95% CI 0.46–2.22, Padj = .045), and sativa-dominant (Mdiff = 1.83, 95% CI 0.68–2.99, Padj = .028) strains were significantly more efficacious than CBD-dominant strains. In anxiety and comorbid conditions, all strain categories were perceived to be efficacious with no significant differences between strains.ConclusionsIn terms of perceptions, individuals with depression, anxiety, and both conditions who use cannabis for insomnia report significant improvements in symptom severity after cannabis use. The current study highlights the need for placebo-controlled trials investigating symptom improvement and the safety of cannabinoids for sleep in individuals with mood and anxiety disorders.

Accumulated unhealthy behaviours and insomnia in Japanese dwellers with and without cardiovascular risk factors: a cross-sectional study

ObjectivesTo date, the association between accumulated unhealthy behaviours and insomnia in individuals stratified according to the presence or absence of major cardiovascular risk factors is unclear. This study aimed to...

Telehealth-Delivered Cognitive Behavioral Therapy for Insomnia in Individuals with Multiple Sclerosis: A Pilot Study.

Background Over 50% of individuals with multiple sclerosis (MS) have moderate or severe sleep disturbances, insomnia being the most common. In-person cognitive behavioral therapy for insomnia (F2F-CBTi) is currently the first-line treatment for insomnia. However, given potential limitations to access including mobility difficulty, fatigue, or living in a rural area, telehealth-delivered CBT-I (tele-CBTi) has been considered as an alternative treatment. The purpose of this study was to assess the feasibility and treatment effect of tele-CBTi in people with MS and compare it to outcomes from a F2F-CBTi study in individuals with MS. Methods 11 individuals with MS and symptoms of insomnia participated in 6 weekly CBT-I sessions with a trained CBT-I provider via live video. Insomnia severity (ISI), sleep quality (PSQI), and fatigue severity (FSS and MFIS) were assessed pre- and posttreatment as primary outcomes. Sleep onset latency (SOL), sleep efficiency (SE) and total sleep time (TST) from the PSQI, depression (PHQ-9), anxiety (GAD-7), sleep self-efficacy (SSES), and quality of life (MSIS-29) were also assessed pre- and posttreatment as secondary outcomes. Results Participants resided in 9 different states. Retention and adherence rates were 100%. There were significant improvements in ISI, PSQI, MFIS, FSS, SOL, SSES, PHQ-9, and MSIS-29, but not SE, TST, or GAD-7. There were no significant differences between the F2F-CBTi group and tele-CBTi group for magnitude of change in the primary outcomes (ISI, PSQI, MFIS, and FSS) or the secondary outcomes (SOL, SE, TST, SSES, PHQ-9, GAD-7, and MSIS-29). Conclusions Tele-CBTi is feasible and has outcome measures that are similar to that of in-person CBT-I treatment. Tele-CBTi may increase access to insomnia treatment in individuals with MS.

Emotional Dysregulation, Anxiety Symptoms and Insomnia in Individuals with Alcohol Use Disorder.

Alcohol craving is associated with insomnia symptoms, and insomnia is often reported as a reason for alcohol relapse. The current study examined associations between emotional regulation, anxiety, and insomnia among a group of 338 patients with alcohol use disorder (AUD). Because insomnia most often develops after stressful experiences, it was expected that anxiety symptoms would mediate the association between emotional dysregulation and insomnia severity. It was also expected that an insomnia diagnosis would moderate the association between emotional dysregulation and anxiety symptoms, namely that higher anxiety levels would be found in individuals with insomnia than in those without insomnia. Insomnia severity was assessed with a total score based on the Athens Insomnia Scale (AIS). Additionally, an eight-point cut-off score on the AIS was used to classify participants as with (n = 107) or without (n = 231) an insomnia diagnosis. Moreover, participants completed the Emotion Regulation Scale (DERS; total score) and the Brief Symptoms Inventory (BSI; anxiety). Individuals with insomnia did not differ from those without insomnia in age (p = 0.86), duration of problematic alcohol use (p < 0.34), mean days of abstinence (p = 0.17), nor years of education (p = 0.41). Yet, individuals with insomnia endorsed higher anxiety (p < 0.001) and higher emotional dysregulation (p < 0.001). Anxiety symptoms fully mediated the association between emotional dysregulation and insomnia severity (p < 0.001). Furthermore, insomnia diagnosis positively moderated the association between emotional dysregulation and anxiety (p < 0.001). Our results suggest that emotional dysregulation can lead to insomnia via anxiety symptoms. Treating anxiety symptoms and emotional dysregulation could help to prevent or alleviate symptoms of insomnia in people with AUD. Moreover, treating insomnia in people with AUD may also have a positive effect on anxiety symptoms.